Algorithm Boosts Pain Management in Patients with Dementia

Evidence-based approach helps nurses reduce pain in elderly patients with cognitive impairment.

Training nurses to use a standardized Pain Recognition and Treatment (PRT) protocol significantly improves pain management in institutionalized patients with dementia, according to a study published in Pain Management Nursing.1

Results showed that adding an evidence-based clinical decision-making algorithm to basic pain education yielded significant reductions in patient-reported pain intensity and pain-related behaviors.

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Institutionalized, cognitively-impaired elderly patients frequently cannot clearly verbalize their pain and discomfort, representing a challenge to diagnosis and treatment that has stimulated considerable research efforts in the last decade.

Among patients with dementia, inadequately controlled pain can have serious consequences, including depression, difficulties with ambulation, impaired sleep, decreased social interaction, and increased health care utilization.2

“Too many professionals and paraprofessionals do not realize that care of older adults is simply not the same as [caring for] younger adults,” Tara A. Cortes, PhD, RN, FAAN, executive director of the Hartford Institute for Geriatric Nursing at New York University told Clinical Pain Advisor.

“As our population of people aged 65 and older grows at a rate of 10,000 each day, we have an urgent need to increase [clinician] awareness that this population has unique ways of exhibiting symptoms, and treatments must be tailored to them,” Dr. Cortes pointed out.

“The PRT protocol not only enhances knowledge about pain management in dementia but, by standardizing the care process, it increases the level of implementation, resulting in adequate pain management and the relief of residents’ pain,” write researchers Yi-Heng Chen, RN, MSN, PhD and Li-Chan Lin, RN, MSN, PhD from the Institute of Clinical Nursing at Taiwan’s National Yang-Ming University.